Task 1 – Explain the Purpose and Role of Research
Florence Nightingale, the most famous nurse of all time believed that statistics were the most important science in the whole world. Through her work in the Crimean War she recognised that to reduce the death rates from preventable disease she had to gather and analyse certain information. Using the evidence she collected she was able to persuade the army to set up a Royal Commission on Health, and left £2000 in her with to set up the first ever university chair of applied statistics. She realised back then which is equally true today, that research is essential to ensure the population receive the best possible healthcare.
Purpose of Research
Health research studies are designed to provide information on health and disease. The purpose of research for the health and social sectors is to learn how our bodies work, why we get sick and what we can do to get and stay well. The ultimate goal is to improve out health. It can help us to understand the type of world we live in.
There are several types of health-related research, some studies are done to learn what causes disease and how to avoid getting sick.
Another extremely important purpose of research is to highlight gaps in health care provision. Some types of research studies include observational studies which follow the same group of people over time to find out what happens to their health. Epidemiological studies look for patterns of disease in large groups of people. A good example of this is every year doctors do epidemiological studies to look at what kinds of flu outbreaks have occurred in the world and then use this information to decide what would be the best vaccine to use to counteract it.
Intervention studies look at ways to change behaviours that effect health for example how increased exercise can affect weight, heart disease and diabetes.
Prevention studies look for ways to keep people from getting sick. These studies often involve people who are at risk for a particular disease, for example people who smoke or have high blood cholesterol which puts them at risk of having a heart attack. Clinical trails are performed to learn the best ways to either prevent or treat a disease. This kind of study tests a new drug, vaccine or medical device. Clinical trails can only begin after results from laboratory studies show that the new treatment is safe to test and likely to be effective in people.
Good research is characterised by applying a logical approach to obtaining and analysing information. There are a number of stages to this logical approach called the research process.
- Selection of the research process
- Literature review
- Aims and objectives of the study
- May have to source funding
- Ethical consideration
- Communication
- Construction of research tools
- Pilot study
- Data collection
- Analysis of the data
- Presentation of the findings of the study
Health Minister Jane Kennedy (2006) said that the requirement to conduct research for the improvement of health and medical treatments was one of the founding principles of the National Health Service.
Health research is essential to tackle the increasing challenges that ill health and disease place on society. The purpose and role of research in the health and social care sector is to, as stated earlier, to ensure that patients and healthcare professionals are able to benefit from it. It will help to improve the quality and speed of services and hopefully provide a world class health and social care infrastructure, provided of course the Government is willing to give support.
Best Research Best Health 2006 sets out a five year research and development strategy for the NHS in England. The department of Health budget for health research for 2006-2007 is in the region of £700million which the Government say will make the UK the best place in the world for health research, development and innovation. They expect research to inform policy and practice and aid reflection. In the NHS research priorities are identified through widespread consultation with those using, delivering and managing services, and take account of the burden of disease, potential benefits and Department of Health objectives as well as the responsibilities and work of other funders including charities, because the Department of Health is not the only funder of health and social care research in the UK. Industry, funding councils, research councils and research charities all play a significant role. According to the DHSS website there are currently 114 charities including the world’s largest charity the Welfare Trust within the association of Medical Research charities covering a wide range of diseases. Their combined expenditure on medical research is £650 million. When one reads this one realises that the Government contribution maybe isn’t that much after all.
Role Research Plays
In the United Kingdom research plays a big part in influencing policy making and practice. It gives people a greater understanding and knowledge of health related subjects, which in turn helps policy makers and politicians to decide where best to target need, and finances.
Inform Policy or Practice
The department of Health continually reviews its priorities for research. In the NHS priorities are identified through widespread consultation with users and carers, as well as those delivering and managing services. They take account of the cost of disease, human and financial, the potential benefits as well as the work and responsibilities of other funders, including the charities.
Plans were announced in January 2007 to give a £20 million boast to public health research. The plan is to create 5 United Kingdom clinical Research Collaborations (UKCRC). Centres of excellence designed to strengthen public health research in the United Kingdom. These centres will bring together leading experts from a range of disciplines working in partnership with practitioners, policy makers and wider stakeholders to tackle complex public health issues such as obesity and smoking that are likely to have a significant impact on the health of the nation. The £20 million investment has been committed by a partnership of funders who have come together under the umbrella of the UKCRC to develop this co-ordinated approach to public health research in the United Kingdom. Funders include our own Research and Development Office for Northern Ireland Health and Personal Social Services. They key aim of the centres will be to build academic capacity and strong training and career development in order to provide the infrastructure needed to support high quality research.
Extended Knowledge and Understanding
Part of the role research plays is to extend our knowledge and understanding of particular subjects. This it does through the use of questionnaires, surveys, tables, graphs and statistics. Extending our knowledge of health and social services can be achieved through reading books on the chosen subject, the internet, census documents etc.
Improve Practice
Other role of research is to improve practice. A comprehensive network structure capable of supporting a wide range of clinical research is being established here is Northern Ireland which will enhance the capacity of the Research and Development community to engage with the larger United Kingdom Research Networks. These networks aim to improve practice in areas such as stroke, diabetes, medicines for children, mental health, cardiovascular, cancers, dementias and neurodegenerative diseases.
Aid Reflection
Research has a role in reviewing health and social care polices and procedures. It can show whether care policies and procedure are having the desired affect on services or if they are actually hindering services.
Monitoring of Progress
Research has a role in monitoring the progress and patterns of disease and also the monitoring of interventions designed to eliminate disease. By examining scatter graphs and bar charts investigators can see of their methods are working or not. This monitoring will help to review changes in social care need.
Examine Topics of Contemporary Importance
Research also has a role in extending our scientific knowledge on particular issues that are very much in vogue and still liable to progress such as obesity, smoking and cancers. Research in these areas is necessary for policy makers and DHSSP to determine if current interventions and technologies (equipment) are adequately targeting need and may show new, more productive ways of working.
People in Research
The original idea for this website came from two frequently asked questions from members of the public asking “How can I get involved?” And research organisations or projects asking “How do we find people who want to get involved?”
Public involvement in health related research is about patients and members if the public getting actively involved in the research process, such as helping to decide what is research, how the research should be carried out and what should be done.
Examples of good and bad research
Kendler.K (2000) stated that the human brain is far and away the most complicated thing we know in the universe. The liver and the kidney and the heart are all miraculous and extraordinarily complicated but they are child’s play compared to the brain, so in recent years genetic research has become a topic of contemporary importance and scientists such as Doctor Kendler from the University of Virginia working along side Doctor Tony o Neill, Mater Hospital and Queens University in Belfast have made substantial progress in identifying the genetic and environmental forces impelling people towards mental illness. For example through a study funded by the Medical College of Virginia called the Genetic Epidemiology of Schizophrenia in Ireland they suggest a gene involved in schizophrenia resides on human chromosome 6. Other researchers reported new evidence for genetic links to manic depression. Zhang.L (2006) reported that a gene is responsible for smoking initiation and nicotine dependence.
Although research will help healthcare professionals to progress their service and also allow progress to be monitored it can also help the process of disease. However some research can be morally and ethically wrong. In 1933 in Tuskegee Alabama, an area of deprived socioeconomic status, high rates of illiteracy and very poor medical care, the population were exploited by the investigators who planted syphilis among them and told them they were being treated for “bad blood”, and denied the individuals any form of anti-syphilitic therapy in order to plot the progress of the disease. When the study was finally exposed in 1972 128 were dead due to syphilis related complications. In the aftermath of the Tuskegee study the American Government revaluated its research practices to prevent such a horrible thing ever happening again and introduced the National Research Act and set up the National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research. (Tuskegee study website). They published the Belmont Report 1976 to provide a framework that would guide the resolution of ethical problems arising during research involving human subjects. The basic ethical principles which apply to all researchers include;
- Respect for Persons, all volunteers are treated as individuals and entitled to protection
- Informed consent … each person as given the opportunity to choose what shall or shall not happen to them. The information they receive should be such that persons can decide whether they wish to participate in the furthering of knowledge or not
- Beneficence
- Do not harm
- Maximise possible benefits and minimise possible harms
- Assessment of risks and benefits
- Justice – fairness in distribution
- To each person an equal share
- To each person according to individual need
- To each person according to individual effort
- To each person according to societal contribution
- To each person according to merit (Belmont Report Website)
Reference: UKCRC update issue 5 spring 2007
Reference: http:www.rdo.centralservicesagency.n-i.nhs.uk
REFERENCE
O’Neill FA, Kendler KS, Walsh D. Regulator of G-protient signalling 4 (RGS4) gene is associated with schizophrenia in Irish high density families. American Journal of Medical Genetics (Neuropsychiatric Genetics) 2004 129B 23-26
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